| Comparison between sevoflurane/remifentanil and propofol/remifentanil anaesthesia in providing conditions for somatosensory evoked potential monitoring during scoliosis corrective surgery. | |
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MedLine Citation:
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PMID: 19115644 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Somatosensory evoked potential (SSEP) monitoring is an important tool in spinal corrective surgery. Anaesthesia has a significant influence on SSEP monitoring and a technique which has the least and shortest suppressant effect on SSEP while facilitating a fast recovery from anaesthesia is ideal. We compared the effect of sevoflurane/ remifentanil and propofol/remifentanil anaesthesia on SSEPs during scoliosis corrective surgery and assessed patients' clinical recovery profiles. Twenty patients with idiopathic scoliosis receiving surgical correction with intraoperative SSEP monitoring were prospectively randomised to receive sevoflurane/remifentanil anaesthesia or propofol/remifentanil anaesthesia. During surgery, changes in anaesthesia dose and physiological variables were recorded, while SSEP was continuously monitored. A simulated 'wake-up' test was performed postoperatively to assess speed and quality of recovery from anaesthesia. The effects of propofol and sevoflurane resulted in SSEP amplitude variability between 18.0% +/- 3.5% to 28.7% +/- 5.9% and SSEP latency variability within 1.3% +/- 0.4% to 2.6% +/- 1.2%. Patients receiving sevoflurane had faster suppression and faster recovery of SSEP amplitude compared to propofol (P < 0.05), although propofol anaesthesia showed less within-patient variability in Cz amplitude and latency (P < 0.05). On cessation of anaesthesia, time to eye-opening (5.2 vs. 16.5 minutes) and toe movement (5.4 vs. 17.4 minutes) was shorter following sevoflurane (all P < 0.05). These findings indicate that propofol produces a better SSEP signal than sevoflurane. However adjustments in sevoflurane concentration result in faster changes in the SSEP signal than propofol. Assessment of neurological function was facilitated more rapidly after sevoflurane anaesthesia. |
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Authors:
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N Y Fung; Y Hu; M G Irwin; B E M Chow; M Y Yuen |
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Publication Detail:
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Type: Comparative Study; Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: Anaesthesia and intensive care Volume: 36 ISSN: 0310-057X ISO Abbreviation: Anaesth Intensive Care Publication Date: 2008 Nov |
Date Detail:
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Created Date: 2008-12-31 Completed Date: 2009-02-17 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0342017 Medline TA: Anaesth Intensive Care Country: Australia |
Other Details:
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Languages: eng Pagination: 779-85 Citation Subset: IM |
Affiliation:
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Department of Anaesthesiology, Duchess of Kent Children's Hospital, Hong Kong. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Anesthesia Recovery Period Anesthetics, Combined / pharmacology Anesthetics, Inhalation / pharmacology Anesthetics, Intravenous / pharmacology Evoked Potentials, Somatosensory / drug effects* Humans Methyl Ethers / pharmacology* Monitoring, Intraoperative / methods* Piperidines / pharmacology* Propofol / pharmacology* Prospective Studies Reaction Time / drug effects Scoliosis / surgery* Time Factors |
| Chemical | |
Reg. No./Substance:
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0/Anesthetics, Combined; 0/Anesthetics, Inhalation; 0/Anesthetics, Intravenous; 0/Methyl Ethers; 0/Piperidines; 132875-61-7/remifentanil; 2078-54-8/Propofol; 28523-86-6/sevoflurane |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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